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The best results in weight loss are achieved when drug treatment is used as an adjunct to a comprehensive programme of diet modification, exercise, and behaviour therapy, a new US study shows.

The randomised one year trial involved 180 women and 44 men between the ages of 18 and 65 whose body mass index was between 30 and 45 (New England Journal of Medicine 2005;353:2111-20). At the beginning of the study the participants were asked to keep to their usual eating and activity habits. Later they were prescribed a balanced deficit diet giving about 5 MJ to 6.3 MJ of energy a day. In this diet about 15% of their energy derived from proteins, 30% or less …